General Information: CARLISLE MANOR HEALTH CARE INC
Nursing home name CARLISLE MANOR HEALTH CARE INC
Address730 HILLCREST DRIVE
CARLISLE, OH 45005
Phone number (937) 746-2662
Located within a hospital No
Type of ownership For profit - Corporation
Owner operates multiple homesYes
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Resident
Certified number of beds 48
Total number of residents 42
Perc of occupied beds 87
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints1
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: CARLISLE MANOR HEALTH CARE INC
Overall rating 5
5
Nursing Home Staffing 2
2
Registered Nurses only 3
3
Health Inspections 5
5
Quality Measures 5
5
Nursing Home Staffing Info: CARLISLE MANOR HEALTH CARE INC
National AverageOhio AverageCARLISLE MANOR HEALTH CARE INC
Overall staff rating NA NA 2
2
Registered Nurses only rating NANA 3
3
Total Number of Residents NA NA 42
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.0 hours 3.18 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.69 hours 1.27 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.79 hours 0.61 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.9 hours 0.66 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.31 hours 1.92 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.07 hours 0.01 hours
Health Survey: CARLISLE MANOR HEALTH CARE INC
Heath Survey Summary on 2013-11-14
Total Number of Health Deficiencies 1
Scope and Severity of most Severe Health Deficiency Pattern/Potential for minimal harm
Heath Survey Summary on 2012-07-31
Total Number of Health Deficiencies 0
Scope and Severity of most Severe Health Deficiency
Heath Survey Summary on 2011-04-03
Total Number of Health Deficiencies 3
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Health Survey Details: CARLISLE MANOR HEALTH CARE INC
Inspection Results: 11/14/2013
Corrected Deficiency Scope and Severity
Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible. Pattern/Potential for minimal harm
Inspection Results: 04/03/2011
Corrected Deficiency Scope and Severity
05/23/2011 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Pattern/Minimal harm or potential for actual harm
05/23/2011 Upon the death of a resident, convey the residents personal funds and an accounting of those funds to the appropriate party. Pattern/Potential for minimal harm
05/23/2011 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm

Fire Safety Survey: CARLISLE MANOR HEALTH CARE INC
Fire Safety Survey Summary on 2013-11-14
Total Number of Fire SafetyDeficiencies 0
Scope and Severity of most Severe Health Deficiency
Fire Safety Survey Summary on 2012-07-31
Total Number of Fire SafetyDeficiencies 1
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-04-02
Total Number of Fire SafetyDeficiencies 5
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey: CARLISLE MANOR HEALTH CARE INC
Fire Safety Survey Results: 07/31/2012
Corrected Deficiency Severity
09/03/2012 Properly protected cooking facilities. Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Results: 04/02/2011
Corrected Deficiency Severity
05/23/2011 An approved automatic sprinkler system connected to the fire alarm system. Pattern/Minimal harm or potential for actual harm
05/23/2011 Properly working alarms on sprinkler valves. Widespread /Minimal harm or potential for actual harm
05/23/2011 Proper backup exit lighting. Pattern/Minimal harm or potential for actual harm
05/23/2011 Proper stairway enclosures and vertical shafts. Isolated/Minimal harm or potential for actual harm
05/23/2011 Weekly inspections and monthly testing of generators. Widespread /Minimal harm or potential for actual harm

Resident Complaints: CARLISLE MANOR HEALTH CARE INC
Date Complaint Substantiated: 03/04/2014
CorrectedCategoryDeficiencySeverity
04/01/2014Permit residents to remain in the facility and not be transferred or discharged without adequate reason. D

Quality Measures: CARLISLE MANOR HEALTH CARE INC
Quality Measures National Average Ohio Average CARLISLE MANOR HEALTH CARE INC
Overall quality rating NA NA 5
5
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 14.3% 13.7%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 8.7% 9.3%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 5.6% 2.2%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 7.4% 8.1%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 38.6% 48.3%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 3.2% 0.0%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 6.0% 0.8%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 14.4% 19.3%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 1.7% 0.0%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 3.4% 0.0%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 92.1% 98.4%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 95.2% 100.0%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 22.8% 24.6%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 22.1% 22.5%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 1.0% 0.0%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 84.9% 81.8%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 85.2% 85.9%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 2.5% 4.2%

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